Health Brief: Aetna to Withdraw From All ACA Exchanges in 2018

Washington Brief

  • To pay for maintaining some of the Affordable Care Act’s expanded coverage, some Republican senators may push to keep certain Obamacare taxes that would otherwise be repealed retroactively in the House-passed bill. (The Wall Street Journal)
  • The Congressional Budget Office said it plans to release its cost estimate of the House GOP health care bill early in the week of May 22. The CBO’s estimate of a previous version of the measure said it would cause 24 million more people to be uninsured by 2026, compared to leaving the 2010 Affordable Care Act intact. (CNBC)
  • President Donald Trump intends to appoint Gov. Charlie Baker (R-Mass.), Gov. Roy Cooper (D-N.C.), former Rep. Patrick Kennedy (D-R.I.) and addiction specialist Bertha Madras to a White House commission that aims to confront the opioid crisis. (Stat News)

Business Brief

  • Aetna plans to withdraw from Obamacare entirely in 2018. The Connecticut-based insurer said it would exit the exchanges in Delaware and Nevada next year, the last two states in which it participated. (The Hartford Courant)
  • Alphabet Inc.’s venture arm GV and other investors put at least $130 million into Clover Health, valuing the insurance startup at $1.2 billion. The startup uses data science for preventative health care. (Bloomberg News)
  • GlaxoSmithKline’s blockbuster lung drug Advair is unlikely to face generic competition in the United States this year after the Food and Drug Administration rejected an application by Hikma Pharmaceuticals to sell a cut-price equivalent form of the medicine. (Reuters)

Chart Review

The Trumpcare Premium
The New York Times

Events Calendar (All Times Local)

Consumer Healthcare Products Association Regulatory Science and Quality Conference 8 a.m.
Senate HELP Committee marks up FDA Reauthorization Act 9:30 a.m.
AEI discussion on practice regulation and health care reform 12 p.m.
Consumer Healthcare Products Association Regulatory Science and Quality Conference 8 a.m.
National Economists Club luncheon on the ACA and AHCA 12 p.m.



Health-Care Bill’s Tax Cuts Aren’t a Done Deal
Richard Rubin, The Wall Street Journal

Don’t count on a retroactive tax cut just yet. Republican senators aren’t sold on a piece of the House-passed health-care bill that makes this past Jan. 1 the effective date for tax cuts on capital gains, health-insurance companies and pharmaceutical companies.

CBO will finally score House Obamacare bill ‘early’ in week of May 22
Dan Mangan, CNBC

Two weeks late might be better than never. An estimate of the costs and impact of the Republican Obamacare replacement bill will be released nearly two weeks after that bill was passed by the House of Representatives, the Congressional Budget Office said Wednesday.

52 ways to repeal Obamacare
Jennifer Haberkorn, Politico

Senate Republicans want to do their own Obamacare repeal plan — but nearly all 52 Republicans have their own ideas about how it should look. With his razor-thin majority, Majority Leader Mitch McConnell can afford to lose only two GOP votes.

Republicans flub defense of health care vote
Kyle Cheney, Politico

House Republicans celebrated passing legislation to repeal Obamacare last week — but apparently forgot to figure out how to talk about the feat back home. The result has been a messaging mess, as lawmakers returned to their districts for a weeklong recess to face furious Obamacare defenders.

MacArthur slammed at town hall for reviving Obamacare repeal
Jonathan D. Salant,

That didn’t take long. The first questioner at Rep. Tom MacArthur’s town hall meeting here Wednesday wanted to know about those who have pre-existing conditions.

Trump’s pick to run mental health is poised to shake things up. Even some liberals can’t wait
Meghana Keshavan, Stat News

President Trump’s pick to run federal mental health services has called for a bold reordering of priorities — shifting money away from education and support services and toward a more aggressive treatment of patients with severe psychiatric disorders. The proposal has some psychiatrists — a generally liberal bunch — cheering despite their distrust of the Trump administration.

Tom Price commends West Virginia officers who arrested journalist asking questions
Andrew Joseph, Stat News

Secretary of Health and Human Services Tom Price on Wednesday commended police in West Virginia for “doing what they thought was appropriate” in arresting a journalist who shouted questions at him, but added that it wasn’t his call to say whether they took the proper measures. Price said the reporter confronted him while he was walking down a hallway. “That gentleman was not in a press conference,” he said.

Europe Stocks Slip as Oil Leads Commodity Rebound: Markets Wrap
Samuel Potter and Cecile Gutscher, Bloomberg News

European stocks drifted lower for the first time in three days as gains for mining and energy shares struggled to offset a broader mood of caution. Gold was poised to snap its six-day losing streak amid a wider commodity bounce.


Abandoning Obamacare, Aetna Withdraws From Last Two States
Stephen Singer, The Hartford Courant

Aetna Inc., which has signaled for months that mounting financial losses would force its exit from Obamacare, announced Wednesday it is quitting the remaining two states in which it participated. The Hartford insurer said it will not offer on- or off-exchange individual plans in Delaware or Nebraska in 2018.

Clover Health Raises $130 Million, Valuing It at $1.2 Billion
Lizette Chapman, Bloomberg News

Clover Health, an insurance startup using data science for preventative health care, has become Silicon Valley’s newest, and a rather reluctant, unicorn. Alphabet Inc.’s venture arm GV and other investors have put at least $130 million into the San Francisco-based company, valuing it at $1.2 billion, according to people familiar with the matter.

Trump Wants $800 Billion, 10-Year Cut in Entitlement Programs
Paul M. Krawzak, Roll Call

White House officials are crafting a fiscal 2018 budget proposal for President Donald Trump that aims to wipe out the deficit through a combination of robust economic growth, steep cuts in certain means-tested entitlement programs and other savings. Trump would aim to balance the federal budget within 10 years.

GOP senators can cut Obamacare taxes or preserve coverage for millions — but probably not both
Noam N. Levey, The Los Angeles Times

As they take up the campaign to replace the Affordable Care Act, Senate Republicans face a critical choice between cutting taxes or preserving health coverage for millions of Americans, two competing demands that may yet derail the GOP push to roll back the 2010 healthcare law. House Republicans, who passed their own Obamacare repeal measure last week, skirted the dilemma by cutting both taxes and coverage.

Parents Of Sick Children Fear Trap If States Have Say On ‘Preexisting Conditions’
Bram Sable-Smith, Side Effects Public Media

Ryan Lennon Fines of Missouri seems like a typical 2-year-old. He and his parents, Scott Fines and Brianna Lennon, flip through a picture book of emergency vehicles.


Kaiser raises record $4.4 billion in white-hot hospital bond market
Dave Barkholz, Modern Healthcare

Kaiser Permanente raised $4.4 billion through a series of three bond offerings this month. That’s a record for the Oakland, Calif.-based health plan and hospital giant, which plans to use the proceeds to fuel expansion, said Chief Financial Officer Kathy Lancaster.

FDA proposes that doctors learn about acupuncture for pain management
Megan Thielking, Stat News

Chiropractors and acupuncturists who have lobbied for a bigger role in treating pain have won a preliminary endorsement from federal health officials. The Food and Drug Administration released proposed changes Wednesday to its blueprint on educating health care providers about treating pain.

Pharma, Biotech and Devices

White House names new members of opioid commission
Andrew Joseph, Stat News

Two governors, a former congressman in recovery, and an addiction researcher are set to join New Jersey Governor Chris Christie on President Trump’s opioid panel. The White House announced Wednesday that the president intended to appoint Republican Governor Charlie Baker of Massachusetts and Democratic Governor Roy Cooper of North Carolina to the Commission on Combating Drug Addiction and the Opioid Crisis.

GSK escapes Advair hit for now as second generic bid fails
Ben Hirschler, Reuters

GlaxoSmithKline is likely to escape generic competition to its blockbuster lung drug Advair in the United States this year, after a second application for a cut-price equivalent form of the medicine was turned down by U.S. regulators. Industry analysts believe the generic threat has now been pushed back until mid-2018, providing Britain’s biggest drugmaker with a short-term profit boost.

Mylan disagrees with FDA over generic Advair rejection
Michael Erman and Natalie Grover, Reuters

Generic drug maker Mylan NV said on Wednesday it disagrees with the U.S. Food and Drug Administration, which declined to approve Mylan’s generic for GlaxoSmithKline Plc’s blockbuster Advair in March. Mylan President Rajiv Malik said the FDA was asking it to comply with standards set out in draft guidance the agency issued, but that it believes it is not required to do so.

Comey turmoil postpones Senate health care markup
David Nather, Axios

The Senate HELP Committee called off a health care markup this morning after Senate Minority Leader Chuck Schumer asked all Democrats to be in the Senate chamber at 9:30 a.m. to protest President Trump’s firing of FBI Director James Comey. The committee said it will reschedule the meeting, where senators were set to approve a bill to reauthorize the user fees that help fund the Food and Drug Administration.

Does the White House need its own drug policy office? A former insider offers a resounding ‘yes’
Andrew Joseph, Stat News

Is the White House’s drug policy office worth the money? A Trump administration proposal to cut the $388 million budget of the Office of National Drug Control Policy by 95 percent has given new urgency to that question, with some administration officials arguing the ONDCP simply duplicates work already done by other agencies.

Health IT

Blue Cross Blue Shield plans will offer free Lyft rides
Bob Herman, Axios

The Blue Cross and Blue Shield Association is partnering with ride-sharing company Lyft (and not Uber) to help people who may not have reliable transportation get to their routine doctors’ appointments. The service will launch in the fall and will be free for people who have commercial Blue Cross and Blue Shield coverage through their jobs.

A Message from PhRMA:

You don’t always pay full price for doctor or hospital visits. So why is a visit to the pharmacy different? Unlike care received at an in-network hospital or physician’s office, patients with high deductibles or coinsurance pay cost sharing based on the list price of a medicine, even if their insurer receives a steep discount. Insurers should share more of the rebates they receive with patients. Get the facts at

Opinions, Editorials and Perspectives

ICER Perpetuates the Opioid Crisis
Robert Goldberg and Peter Pitts, Morning Consult 

Last year, a week before Christmas in Kerville, Pennsylvania, 5-month-old Summer Chambers died in her crib from dehydration and starvation. Her parents — Jason Chambers, 27, and Chelsea Cardaro, 19 — had died about four days earlier from a non-abuse-deterrent opioid overdose.

The Drug Lobby’s In-House Hygiene
The Editorial Board, The Wall Street Journal

This week’s non-Comey news file contains an encouraging development for U.S. medical innovation amid the running political debate over pharmaceutical prices. The main drug lobby ousted 22 members and adopted corporate governance reforms.

The moral travesty of Trumpcare
Robert B. Reich, The Baltimore Sun

Shame on every one of the 217 Republicans in the House of Representatives who voted to repeal the Affordable Care Act last Thursday and substitute it with basically nothing. Trumpcare isn’t a replacement of the Affordable Care Act.

Fact Checking Health-Care Hysteria
Karl Rove, The Wall Street Journal

After the House voted last week to repeal and replace ObamaCare, Democrats quickly launched a barrage of false attacks. Minority Leader Nancy Pelosi asserted that the bill would “gut” protections for patients with pre-existing conditions.

What Spain Gets Right on Health Care
Carolyn McClanahan, The New York Times

First came the Affordable Care Act, then the American Health Care Act — time and again, politicians talk about controlling health care costs but end up missing the point. Based on the historical rate of inflation, health care spending could consume nearly 50 percent of gross domestic product in 30 years — an unsustainable trend that can’t be solved through changing the insurance landscape.

Rich parents get away with not vaccinating their children. Poor ones don’t.
Linda C. Fentiman, The Washington Post 

Public health experts once again must defend the safety — and necessity — of vaccination, this time in response to misinformation spread among the Somali community in Minnesota by anti-vaccine activists. The rising skepticism about vaccines is dangerous on its own, of course.

A Message from PhRMA:

DID YOU KNOW more than 1/3 of the list price for brand medicines is rebated back to payers and the supply chain? Yet, unlike care received at an in-network hospital or physician’s office, patients with high deductibles or coinsurance pay cost sharing based on a medicine’s list price, even if their insurer receives a steep discount. Patients share the costs of medicines, so they should share the savings. Learn more at

Research Reports

Proposed Medicaid Section 1115 Waivers in Maine and Wisconsin
MaryBeth Musumeci et al., Kaiser Family Foundation

While Congress continues to consider repeal and replacement of the Affordable Care Act (ACA) as well as fundamental changes to the structure and funding of the Medicaid program, states and the Administration may achieve major changes to Medicaid through the use of Section 1115 Medicaid waivers. Section 1115 Medicaid demonstration waivers provide states with an avenue to test new approaches that further the objectives of the Medicaid program in ways that differ from what states can do under current law.